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Waiting times for carotid endarterectomy in UK: observational study.

Halliday, AW; Lees, T; Kamugasha, D; Grant, R; Hoffman, A; Rothwell, PM; Potter, JF; Horrocks, M; Naylor, R; Rudd, AG; et al. Halliday, AW; Lees, T; Kamugasha, D; Grant, R; Hoffman, A; Rothwell, PM; Potter, JF; Horrocks, M; Naylor, R; Rudd, AG; Carotid Endarterectomy Steering Group; Clinical Effectiveness and Evaluation Unit, Royal College of Phy; Vascular Society of Great Britain and Ireland (2009) Waiting times for carotid endarterectomy in UK: observational study. BRITISH MEDICAL JOURNAL, 338 (b1847). ISSN 0959-8146 https://doi.org/10.1136/bmj.b1847
SGUL Authors: Halliday, Alison Wynne

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Abstract

OBJECTIVES: To assess timeliness of carotid endarterectomy services in the United Kingdom. DESIGN: Observational study with follow-up to March 2008. SETTING: UK hospitals performing carotid endarterectomy. PARTICIPANTS: UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007. MAIN OUTCOME MEASURES: Provision and speed of delivery of appropriate assessments of patients; carotid endarterectomy and operative mortality; 30 day postoperative mortality. RESULTS: 240 (61% of those eligible) consultant surgeons took part from 102 (76%) hospitals and trusts. Of 9913 carotid endarterectomies recorded on hospital episode statistics, 5513 (56%) were included. Of the patients who underwent endarterectomy, 83% had a history of transient ischaemic attack or stroke. Of these recently symptomatic patients, 20% had their operation within two weeks of onset of symptoms and 30% waited more than 12 weeks. Operative mortality was 0.5% during the inpatient stay and 1.0% (95% confidence interval 0.7% to 1.3%) by 30 days. CONCLUSION: Only 20% of symptomatic patients had surgery within the two week target time set by the National Institute for Health and Clinical Excellence (NICE). Although operative mortality rates are comparable with those in other countries, some patients might experience disabling or fatal stroke while waiting for surgery and hence not be included in operative statistics. Major improvements in services are necessary to enable early surgery in appropriate patients in order to prevent strokes.

Item Type: Article
Additional Information: © Halliday et al 2009. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Aged, Brain Ischemia, Carotid Artery Diseases, Endarterectomy, Carotid, Female, Follow-Up Studies, Great Britain, Hospital Mortality, Humans, Male, Stroke, Waiting Lists, Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, TRANSIENT ISCHEMIC ATTACK, RECURRENT STROKE, MINOR STROKE, STENOSIS, SURGERY, RISKS, SYMPTOMS, DELAYS, AUDIT
Journal or Publication Title: BRITISH MEDICAL JOURNAL
ISSN: 0959-8146
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Dates:
DateEvent
4 June 2009Published
Web of Science ID: WOS:000266726400002
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URI: http://openaccess.sgul.ac.uk/id/eprint/702
Publisher's version: https://doi.org/10.1136/bmj.b1847

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